Medical Billing Denials & Appeals Specialist

AI overview

Manage denied insurance claims and ensure timely resolution while collaborating with teams and communicating effectively with insurance companies to optimize reimbursements.

Job Title: Medical Billing Denials & Appeals Specialist
Schedule: Full-Time | Monday to Friday | 9:00 AM – 5:00 PM

Job Overview:
We are seeking a detail-oriented and proactive Medical Billing Denials & Appeals Specialist to join our team. In this role, you will be responsible for managing denied insurance claims, communicating directly with insurance companies, and ensuring timely resolution of outstanding accounts. The ideal candidate is confident on the phone, organized, and knowledgeable in medical billing processes.

Key Responsibilities:

  • Review and analyze denied or rejected insurance claims
  • Contact insurance companies via phone to follow up on claim status and denials
  • Submit appeals with proper documentation and supporting information
  • Provide accurate patient and claim information to insurance representatives as needed
  • Identify root causes of denials and recommend corrective actions
  • Maintain detailed notes and updates in the billing system
  • Ensure timely resolution of claims to optimize reimbursement
  • Collaborate with internal teams to gather required documentation

Requirements

  • Proven experience in medical billing, specifically denials and appeals
  • Strong understanding of insurance processes, EOBs, and claim adjudication
  • Excellent verbal communication skills (comfortable handling high call volumes)
  • Strong attention to detail and problem-solving skills
  • Ability to manage multiple accounts and meet deadlines
  • Proficient in medical billing software and Microsoft Office

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